WASHINGTON – Sens. Chuck Grassley (R-Iowa) and Roger Wicker (R-Miss.) introduced the Medical Foods and Formulas Access Act to help Americans with digestive or inherited metabolic disorders access the nourishment they need.
The legislation would require Medicare, Medicaid, the Children’s Health Insurance Program and the Federal Employee Health Benefit Program to cover specialized formulas, vitamins, individual amino acids and other medically necessary foods prescribed for patients with specific gastrointestinal and inherited metabolic disorders.?The legislation ensures state and federal protection for existing coverage.
“Patients with cystic fibrosis, Crohn’s disease or other inherited disorders can get very sick without specialized foods. They may suffer problems like stunted growth or even death if their special nutritional needs aren’t met. Our bipartisan legislation would ensure government insurance plans provide coverage for the nutrition they need to thrive. It makes clear that medical nutrition is just as critical for certain patients as prescription drugs or other medical treatment are for others,” Grassley said.
“It is crucial that Americans with digestive or inherited metabolic disorders have the nourishment they need. When medical food and formula is necessary, time is of the essence. Metabolic disorders are treatable with the right resources. This legislation would ensure medically necessary nutrition is covered by government health programs,” Wicker said.
Additional cosponsors include Sens. Amy Klobuchar (D-Minn.) and Sheldon Whitehouse (D-R.I.). Companion legislation was introduced in the House of Representatives by Reps. John Rutherford (R-Fla.), Debbie Dingell (D-Mich.) and Jim McGovern (D-Mass).
Full text of the legislation can be found HERE.
Background:
Medically necessary nutrition must be specially formulated and processed, as opposed to naturally occurring food. The legislation provides coverage for patients receiving active and ongoing medical supervision. Nearly 40 states require coverage of medically necessary nutrition, but that coverage varies by state.
Around 2,000 infants are diagnosed with an inherited metabolic disorder every year. When these conditions are left untreated, food can become toxic, or necessary nutrients aren’t properly absorbed. Pediatric risks of these diseases include inadequate growth, abnormal development, cognitive impairment and behavioral disorders.
These patients require medically necessary nutrition prescribed by a health care provider to treat their conditions, including highly specialized formula. Many conditions can’t be managed solely by avoiding certain foods.